Introduction: There are only limited data about perinterventional pain during cardiac implantable electronic devices (CIEDs) surgery procedures. Proper management of peri-interventional pain relieves unwarranted patient distress and enhances patient satisfaction. Aim: The aim of this study was to analyze perioperative pain intensity among patients undergoing CIED surgery and to compare perioperative pain management practice with published guidelines. Methods and results: Fifty eight consecutive patients (mean age 75 years, 39 men) were asked to quantify perinterventional pain on a numeric rating scale (NRS 0–10) before, during, and after the procedure (device surgeries in local anaesthesia with lidocaine 1%). Pain was classified as moderate to severe in case of NRS > 3. Patients didn't receive analgesia or sedation before surgery. Post-operative pain medication included non-opioid and opioid analgesics. In total, twenty patients (34%) suffered from moderate-to-severe pain during the procedure, eight (14%) 1h, seven (12%) 3h and three (5%) 6h after the procedure. Procedure of CIED implantation was associated with higher intensity of pain (48% patients reported NRS>3) then replacement procedure (6% NRS>3). Gender and age weren't associated with peri-interventional pain. After surgery, 7 % of patients received pain medication. Guidelines for acute perioperative pain management were not implemented as standard of care. Conclusion: The findings highlight the high prevalence of moderate-to-severe peri-interventional pain during CIED surgery procedures, despite the use of conventional analgesics. Higher doses of sedation and intensive analgesia may be required. Practice for pain management should be according guidelines for acute perioperative pain management and anesthesia.